Author + information
- Sherif Rizk Youssef Rizk,
- Wasseem Gobran,
- Karim Said,
- Hala Hamza,
- Jane Burns,
- John Gordon,
- Lori B. Daniels,
- Ryan Reeves,
- Galal El Said and
- Kasr El Aini
Differentiating coronary artery aneurysm (CAA) due to Kawasaki disease (KD) versus atherosclerosis can be challenging but is important because the management and prognosis of each condition differs. Our aim is to assess the role of IVUS and FFR in differentiating CAA due to KD versus atherosclerosis.
50 patients (median age: 52 years; range: 9 - 60) with 88 CAAs documented by invasive coronary angiography were prospectively recruited. CAAs were diagnosed if the internal diameter ≥1.5 times that of an adjacent segment and were classified based on history of KD and angiographic appearance as follows: KD (n=25); atherosclerotic (n=16); and equivocal (n=9). CAAs were evaluated using IVUS and FFR.
The following table summarizes the difference between KD and atherosclerotic CAAs;
KD aneurysms had characteristic myointimal proliferation by IVUS. In the absence of obstructive disease, CAAs are associated with reduction of FFR especially in KD patients. In 18% of patients features of both KD and atherosclerosis co-exist. IVUS is more sensitive in detecting thrombi within CAAs than conventional angiography, which leads to underestimation of CAA size. IVUS and FFR can help to distinguish CAAs due to KD versus atherosclerosis and should be considered in the evaluation of all patients with CAAs.
Poster Hall, Hall A/B
Saturday, March 10, 2018, 10:00 a.m.-10:45 a.m.
Session Title: Plaque Morphology and Intravascular Imaging
Abstract Category: 23. Interventional Cardiology: IVUS and Intravascular Physiology
Presentation Number: 1115-269
- 2018 American College of Cardiology Foundation